When Kayleigh Ferguson-Walker returned to church for the first time since losing her arms and legs, she wore a bright yellow dress.

She sat in a wheelchair that her husband, Ramon, pushed to the front of the sanctuary. Her legs, missing below the knee, were covered by a blanket. The stump of her right arm, severed above the elbow, was wrapped in a white bandage. Her left arm ended just below the elbow.

The pastor lowered a microphone, and Kayleigh, 31, addressed the congregation in a soft, slightly hesitant voice.

“Today I’m just amazed to be here, to be able to talk, to see, to praise God,” she said.

“I was in a coma for two weeks. But when I woke up, I woke up. And God, he had a different plan for me. And I looked around, and I said to myself, I can be depressed about this, or I can just go through...

“In the hospital bed, I was talking to God. Sometimes I even questioned him in my early stages. I asked God, why? Why me? But I knew then there was a great future ahead of me.

“I stay positive for my daughter,” she said, looking over at her toddler, Aaliyah, in the first row. “She wants to lift me up, to feed me. She knows my situation.

“I love you all,” Kayleigh told the 150 parishioners present, many now with tears in their eyes. “I’m glad to be back in the house of the Lord. I’m going to be walking up in here soon.”

A stunningly quick chain of events led the healthy, young, working mom to a rare case of quadruple amputation. On a Saturday evening in March, she was six months pregnant with her second child when she suddenly felt her world begin to fall apart from the inside out.

What had at first seemed like a bad case of the flu quickly turned to chills, vomiting and a racing heartbeat, and Ramon bundled his wife and their daughter into the family car and raced to Broward Health Coral Springs, about 2 ½ miles from their apartment.

In the emergency room, doctors went into overdrive to save the life of a woman now being buffeted by a perfect storm of calamity: Her breathing was labored, her vision blurred, and her blood pressure was dropping. With her kidneys failing, she could not provide a urine sample.

“That was the first of so many nights I didn’t think she would make it,” said Kayleigh’s obstetrician-gynecologist, Dr. Linda Green, who rushed to the hospital after being called at home.

When the baby’s heartbeat could not be detected, Kayleigh was given the medicine Pitocin to induce contractions. The child was stillborn. The son the couple had already named was lost.

The losses did not end there.

In the minutes that followed, it became clear to the hospital medical staff that the infection that had claimed the life of the baby had also infected the mother. Kayleigh had developed sepsis, an illness in which her body’s response to infection had become so overwhelming that it was now threatening her life.

Sepsis is the body’s overwhelming — often life-threatening — response to infection.

Sepsis is responsible for more deaths in the United States than AIDS, prostate cancer and breast cancer combined. It contributes to one in every two to three in-hospital deaths, according to researchers at the University...

(Mike Clary)

As septic shock set in, her blood-clotting mechanism began to work overtime, pulling blood from the extremities in order to protect the vital organs such as the heart, kidneys and liver by giving them a greater amount of blood.

Kayleigh was rushed to ICU, where she was given antibiotics, sedated and put into a coma. There she stayed for the next two weeks as family and friends huddled over her, praying aloud, and watching helplessly as gangrene set in and the young woman’s arms and legs withered and died.

Ultimately, her limbs could not be saved.

Sepsis, a furtive killer

Kayleigh likely contracted sepsis through a complication in her pregnancy caused by a rare condition known as incompetent cervix, in which pressure from the growing baby may cause the cervical tissue to open prematurely, according to Green. The condition can increase the risk of infection.

In the ICU at Broward Health Coral Springs, Kayleigh was hooked up to a respirator and a kidney dialysis machine. Ramon was at her side almost around the clock, along with his parents, Pam and Hugh Ferguson-Walker, both ministers; and Kayleigh’s parents, Laurel and Charles Robinson.

As Green and other doctors worked to keep Kayleigh’s blood pressure up, family and friends massaged Kayleigh’s limbs. They stroked her brow. They leaned over her comatose body in the hospital bed and begged for deliverance. “God save these limbs,” they prayed.

Among those who spent hours at Kayleigh’s bedside was her aunt, Maxine Cunningham, who works as a nurse at the Coral Springs hospital. “At first we were hoping she might only lose a hand, maybe up to the wrist,” Cunningham said.

But the limbs continued to swell, to become more discolored. Kayleigh was unable to move her legs or her arms.

“We were hoping and praying that things would turn around,” Cunningham said. “But reality set in.”

Kayleigh’s life was saved. But nothing could stop the steady shriveling and discoloration of her hands and feet.

When Kayleigh regained consciousness, she saw what had happened. “My hands and feet were pitch black, dead,” she said. “But I was not alarmed. I just looked at them. These were my hands, my feet, and I can’t move them at all. It was not a good sight.”

‘Outside the realm of comprehension’

Dr. James Fletcher, a plastic surgeon, first saw Kayleigh on April 12, after she had emerged from the coma and been transferred to Broward Health Medical Center in Fort Lauderdale, a Level 1 trauma center. He immediately knew what had to happen.

“She was responsive and talkative, and that was remarkable in itself,” said Fletcher, who practices in Fort Lauderdale. “But her general condition was not good. Her four limbs were not viable. Gangrene had led to actual mummification.”

Worse, her limbs had become extremely toxic to Kayleigh. “Dead cells can get washed back into the body, so there is an urgency to act,” Fletcher said.

Before Fletcher could act, he had to make sure his patient and her extended family understood there were no other options. The choice was life or death, amputation or brain damage.

“There was no way to do it except tell them directly in terms they would understand,” he said. “This is the most horrible thing. But she is healthy, and we’re going to keep her alive, preserve function. It is a miracle she didn’t die.”

Fletcher explained that he would take only as much of each limb as necessary, cutting to where the tissue was still being nourished and viable. Saving as much of each arm and leg as he could would help with reconstruction and eventual prosthetics.

Still, relatives and friends pressed him: What could be done short of amputation? Would Kayleigh lose just fingers and toes, or more than that? They asked about hyperbaric oxygen therapy. They asked about bypassing the blood clots, about the risks of brain damage. They asked about the chances of another miracle.

“For the family, it was shocking, outside the realm of comprehension,” Fletcher said. “They wanted to explore all options. We looked to see if there was anything else on the planet that could be done. There wasn’t.”

On the eve of her first surgery, the surgeon described Kayleigh as “peaceful, very accepting. She said, ‘Do what you need to do.’”

Fletcher took Kayleigh’s arms and hands on April 19 with what is called a guillotine amputation. The skin and tissue were cut with a scalpel, the arteries and nerves tied off. The wounds were left open, to be closed later.

Her right arm was severed above the elbow, the left arm about 3 inches below the elbow.

Two days later, Fletcher and specialists on the hospital’s orthopedic surgery team took Kayleigh’s legs below the knees.

“When I woke up, I looked at my arms, and they were not there,” said Kayleigh. “I tried to move my legs. They did not move.

“This was a hard state to be in. But I did not break out crying. Of course I asked, ‘Why me, how me? Why me, God? How am I going to do this? I have a young child.’”

Laurel Robinson, Kayleigh’s mom, said, “I found it really hard to accept. She’s … going to come out without arms and legs.

“But eventually we all drew strength from our daughter.”

Said Green, her obstetrician-gynecologist: “She is the most inspiring individual I’ve ever had the privilege of caring for in more than 30 year of practice. Her story is going to inspire.”

‘Her heart spoke to me’

Both Kayleigh and Ramon have family roots in Jamaica. His family moved to South Florida from New Jersey. Her parents arrived here in 2003 from England, where Kayleigh was born. She was 16 when she enrolled at Marjory Stoneman Douglas High School in Parkland.

The couple met in 2005 at a church picnic. For Ramon, who had never had a serious girlfriend, the meeting was instantly fateful.

“It struck me: Here she is. Her heart spoke to me,” said Ramon, 35. They were married Sept. 17, 2011.

At Broward College, Kayleigh flirted with careers in cosmetology and nursing, then found a home as a pharmacy technician at a Coral Springs Walgreens. She remains on medical leave from that job.

This Sept. 2, Kayleigh and Ramon returned to the place they were married, Praise Tabernacle International in Plantation, for what was billed as her welcome home. “It’s been tough, a little bit fearful,” Ramon, a church deacon, told the congregation. “But today’s an opportunity to celebrate her.”

After Kayleigh spoke, and the applause died down, Pastor Dywane Dawkins, who married the couple, picked up the microphone.

“The hands that [Ramon] put the ring on at the altar, those hands are now gone,” Dawkins said.

“There is shock and sadness. Why did God allow this to happen?” Dawkins paused, then continued. “When we don’t understand it, we say, ‘Yes.’ We’re believers.”

A new reality

Nearly 2 million U.S. residents are amputees, according to the Amputee Coalition, and about 507 amputations take place every day.

But the loss of all four limbs, from causes like sepsis and other extreme illness and trauma, “is quite rare, and often brings additional health challenges and a dramatic life shift,” said Karen Lundquist, a spokeswoman for the nonprofit Amputee Coalition.

The function and mobility in Kayleigh’s future are being designed by Hanger Clinic, a company that fashions orthotics and prosthetics and traces its origins to one of the first amputees of the American Civil War. Matthew Klein, Hanger’s South Florida area manager who is working with Kayleigh, said one of the biggest challenges quadruple amputees face is “getting in and out of prostheses independently.

“But as technology goes, there is nothing stopping her from becoming independent. From the first day I saw her in the hospital, she has had a very positive outlook, a strong support system, a great smile,” he said. “I think she has the will to do this.”

While waiting for her limbs to heal sufficiently to be fitted with prosthetic arms and legs, Kayleigh is attending Hanger-sponsored peer group support meetings. She has met amputees who serve as inspiration and has made progress in rebuilding her life. She exercises regularly under the guidance of physical therapists. She has learned to feed herself with a spoon or fork strapped to the stump of her left arm. By using an edge of that stump, Kayleigh can answer and dial her cellphone. She communicates online by manipulating a stylus she holds in her mouth.

But there is so much she cannot yet do, and the frustrations of her new reality are never far from the surface.

Her mother, Laurel, is battling multiple myeloma, a blood cell cancer, and is recovering from a bone marrow transplant.

“I would like to be able to get up and get things for her,” Kayleigh said.

Kayleigh also is mother to a child, 3, who is struggling to comprehend what has happened to her mom, who can no longer hug her as she once did.

“What I miss with Aaliyah is braiding her hair, taking her for a drive, making a meal, giving her a bath, putting on her clothes,” she said. “A bike ride, swimming with her.”

When tears come to her daughter’s eyes, or her own, Kayleigh cannot easily wipe them.

“You have to expect me to sometimes not to be ‘happy Kayleigh’ 100 percent of the time,” she said. “I have my moments. We all have those moments.

“But I have no fear. I am going to find a way. I may take longer than the next person, but I will find a way. I keep fear out of my mind.”

Kayleigh and Ramon are not represented by a lawyer. They have no plans at this point to sue anyone.

“Everything happens for a reason. Unfortunately, it happened to us,” Ramon said. “I have a feeling there is a bigger purpose out there for Kayleigh and myself. I am not sure how far it’s going to go, or where, but this thing we’re going to be part of, it’s big.”

Although the couple has some health insurance, the costs of her hospitalization, treatment and prosthetic limbs could run into the millions of dollars, according to Fletcher. Relatives have set up a GoFundMe.com account in her name.

The couple said they are trying to strike a balance between the future and now. “Kayleigh lives in the moment. I’m looking five years ahead,” he said.

“I look at my wife and I don’t see a disabled person. I see her abled, with prosthetics,” added Ramon, who has returned to work as a mortgage analyst for a Boca Raton firm. “She’s going to walk, cook, do things for herself. I am confident that’s going to happen. As years go by, she’s going to get the help she needs,” he said. “It might look like it’s devastating, the worst thing that could happen to someone. But it’s life.”

Kayleigh herself imagines coming home as usual after a day of work at Walgreen’s, and Aaliyah is there to greet her as before.

“Every time I came home from work, I would dance with her,” said Kayleigh. “So I say to her, when I get my legs, the first thing we’re going to do is dance. And that puts a big smile on her face.”